Lung cancer relapse in total intravenous and inhaled anesthesia in video-assisted thoracic surgery

Abstract Background:: This study aimed to investigate the recurrence of lung cancer following resection with total intravenous anesthesia and volatile anesthetics.Methods: Patients who underwent surgical resection for lung cancer between January 2015 and April 2020 were analyzed for clinical data, anesthesia, surgical approaches, and outcomes.Results: Overall, 1087 patients with lung cancer were identified and grouped according to whether they received propofol or sevoflurane anesthesia based on intubation status. A total of 321 and 758 patients who received propofol and sevoflurane anesthesia were eligible for analysis, respectively. After propensity score matching, 317 patients remained in each group. Sex, tumor size, operative time, and age differed significantly between both groups. Those who received sevoflurane and propofol anesthesia had a 5-year overall survival rate of 91.2% and 95.6% (p = 0.52) and a 5-year disease-free survival rate of 83.2% and 85.3% (p = 0.711), respectively. Multivariate Cox-regressions analysis revealed that operative time and tumor size were independent factors for postoperative relapse.Conclusions: Total intravenous anesthesia can be safely administered for patients requiring surgery. Moreover, this retrospective study showed no significant difference in relapse rates between anesthesia types over the initial 5 years after surgical resection for lung cancer.Trial registration: This study is retrospectively registered in institutional review board of Tri-service general hospital (TSGHIRB B202105116).